Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Angiotensin Converting Enzyme Inhibitors and the Risk of Lung Cancer – New Scientific Evidences or Another Example of “Pseudo-Evidence” Medicine?

https://doi.org/10.20996/1819-6446-2018-14-6-887-890

Full Text:

Abstract

The quality of the database analysis that led to the conclusion that angiotensin converting enzyme inhibitors contribute to the development of lung cancer is analyzed. The author notes that the analysis of the potential risk from taking these drugs is possible only if it is related to the proven positive effect of these drugs on the prognosis of life in certain categories of patients, primarily with chronic heart failure and a history of acute myocardial infarction. Attention is drawn to the methodological errors of the study, putting the main conclusion of the analysis into question.

About the Author

S. Yu. Martsevich
National Medical Research Center for Preventive Medicine
Russian Federation
MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy


References

1. Avorn J. Two Centuries of Assessing Drug Risks. New Engl J Med. 2012;367;3:193-7. doi:10.1056/NEJMp1206652.

2. Barter P.J., Caulfield M., Eriksson M. et al. ILLUMINATE Investigators. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med. 2007;357(21):2109-22. doi:10.1056/NEJMoa 0706628.

3. ISPE. Guidelines for good pharmacoepidemiology practices (GPP). Pharmacoepidemiology and Drug Safety. 2008;17:200-8. doi:10.1002/pds.1471.

4. CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316(23):1429-35. doi:10.1056/NEJM198706043162301.

5. Zannad F., Anker S.D., Byra W.M. et al. COMMANDER HF Investigators. Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. N Engl J Med. 2018;379(14):1332-42. doi:10.1056/NEJMoa1808848.

6. Martsevich S.Yu., Navasardyan A.R., Zakharova N.A., Lukyanov M.M. New oral anticoagulants: can the results of international controlled studies with these drugs be transferred to Russian patients? Cardiovascular Therapy and Prevention. 2015;14(5):48-52 (In Russ.)

7. PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet. 2001;358(9287):1033-41. doi:10.1016/S0140-6736(01)06178-5.

8. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-convertingenzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342:145-53. doi:10.1056/NEJM200001203420301.

9. Beckett N.S., Peters R., Fletcher A.E. et al. HYVET Study Group.Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887-98. doi:10.1056/NEJMoa0801369.

10. Pfeffer M.A., Braunwald E., Moye L.A. et al. for the SAVE Investigators. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction and myocardial infarction: results of the Survival and Ventricular Enlargement Trial. N Engl J Med. 1992;327:669-77. doi:10.1056 / NEJM199209033271001.

11. Savarese G., Costanzo P., Cleland J. et al. A meta-analysis reporting effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in patients without heart failure. J Am Coll Cardiol. 2013;61:131-42. doi:10.1016/j.jacc.2012.10.011.

12. Hicks M.B., Filion K.B., Yin H. et al. Angiotensin converting enzyme inhibitors and risk of lung cancer: population based cohort study. BMJ. 2018;363:k4209. doi:10.1136/bmj.k4209.

13. ACE inhibitors can increase the risk of cancer. Medicine news. Russian Medical Journal. [cited by Nov 20, 2018]. Available at: https://www.rmj.ru/news/ingibitory-apf-mogut-povysit-risk-vozniknoveniya-raka/. [Ингибиторы АПФ могут повысить риск возникновения рака. Новости медицины. Российский Медицинский Журнал. [цитировано 20.11.2018]. Доступно на: https://www.rmj.ru/news/ingibitory-apf-mogut-povysit-risk-vozniknoveniya-raka/].

14. Ford E.S., Ajani U.A., Croft J.B., et al. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med. 2007;356:2388-98. doi:10.1056/NEJMsa053935.

15. Cronin-Fenton D. Angiotensin converting enzyme inhibitors and lung cancer. Any extra risk must be balanced against the mortality benefits of ACE use. BMJ. 2018;363:k4337. doi:10.1136/bmj. k4337.

16. Gliklich R.E., Dreyer N.A., Leavy M.B. eds. Registries for Evaluating Patient Outcomes: A User’s Guide. 3rd ed. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014

17. Danaei G., Tavakkoli M., Herman M.A. Bias in observational studies of prevalent users: lessons for comparative effectiveness research from a meta-analysis of statins. Am J Epidemiol. 2012;175:250-62. doi:10.1093/aje/kwr301.

18. Center for drug evaluation and research. Application number: 207620Orig1s000. MEDICAL REVIEW(S) [cited by Nov 20, 2018]. Available at: https://www.accessdata.fda.gov/ drugsatfda_docs/nda/2015/207620Orig1s000MedR.pdf.

19. Sipahi I., Debanne S.M., Rowland D.Y. et al. Angiotensin-receptor blockade and risk of cancer: metaanalysis of randomised controlled trials. Lancet Oncol. 2010;11(7):627-36. doi:10.1016/S1470-2045(10)70106-6.

20. D’Agostino R.B. Tutorial in biostatistics propensity score methods for bias reduction in the comparison of a treatment to а non-randomized control group. Statist Med. 1998;17:2265-81.


For citation:


Martsevich S.Y. Angiotensin Converting Enzyme Inhibitors and the Risk of Lung Cancer – New Scientific Evidences or Another Example of “Pseudo-Evidence” Medicine? Rational Pharmacotherapy in Cardiology. 2018;14(6):887-890. https://doi.org/10.20996/1819-6446-2018-14-6-887-890

Views: 89


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)